ESO East Supplement 2023 - 11

Palaiodimou et al.
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Table 3. Baseline characteristics of patients with acute ischemic stroke who received acute reperfusion treatment versus controls
before and after propensity-score matching (PSM).
Baseline characteristics
Before PSM
Site
Age, median (IQR)
Male, n (%)
In-hospital stroke, n (%)
Recurrent stroke, n (%)
NIHSS, median (IQR)
Treated
(n = 525)
-
68 (57-77)
310 (59)
37 (7)
47 (10)
10 (5-16)
Controls
(n = 2143)
-
1341 (63)
57 (3)
237 (12)
3 (1-6)
p Value
<0.001a
64 (55-73) <0.001b
0.129a
<0.001a
0.167a
<0.001b
After PSM
Treated
(n = 296)
-
69 (57-77)
181 (61)
16 (5)
37 (13)
8 (4-13)
IQR: interquartile range; NIHSS: National Institutes of Health Stroke Scale; PSM: propensity score matching.
Patients who received acute reperfusion treatment are denoted as " Treated " versus untreated patients denoted as " Controls. "
aχ2 tests.
bMann-Whitney U tests.
Controls
(n = 296)
-
67 (59-78)
197 (67)
23 (8)
41 (14)
7 (4-14)
p Value
0.863a
0.841b
0.171a
0.501a
0.722a
0.214b
Figure 2. Bar chart depicting the association of acute reperfusion treatment and excellent clinical outcome at discharge of acute
ischemic stroke patients in Greece (OR 1.88; 95% CI 1.35-2.61; p < 0.001; Panel (a)). Bar chart depicting the association of acute
reperfusion treatment and good clinical outcome at discharge of acute ischemic stroke patients in Greece (OR 1.95; 95% CI
1.40-2.72; p < 0.001; Panel (b)).
our cohort during the period 2017-2021 decreased compared
to a previously published Greek cohort from the Safe
Implementation of Thrombolysis in Stroke: International
Stroke Thrombolysis Register (SITS-ISTR) registry during
the time epoch 2002-2017 (40 (IQR 50) vs 67 (IQR 42)
minutes, respectively).44 Furthermore, more patients
received IVT within the golden hour in sites that maintained
registry participation during the 5-year period, confirming
that stroke registries implementation may improve
time metrics in stroke care.34 Certainly, there is still room
for improvement, in order to further reduce time delays in
treatment administration and achieve shorter targets for
DTN and DTG.43,45 Importantly, the odds of receiving acute
reperfusion therapies increased by 30% in the time epoch
2020-2021 compared to the time epoch 2017-2019, pointing
toward a wider implementation of acute stroke
pathways allowing for prompt treatment delivery, despite
COVID-19-associated restrictions to the healthcare system
and persistent declines of acute stroke hospitalizations during
both the first and the second wave of the pandemic in
Greece.46,47 Notably, when massive COVID-19 screening
became available, COVID-19 was diagnosed in 1.7% of
acute stroke patients; a rate which is in accordance with
previous studies and further implies the association between
COVID-19 and cerebrovascular events.48,49
Baseline stroke severity, as measured by the NIHSSscore,
was higher in AIS patients that received acute reperfusion
therapies compared to those that did not (median
NIHSS 10 points (IQR 5-16) vs 3 points (IQR 1-6)). This
finding may indicate that clinicians tend to treat with IVT
and/or EVT patients with more severe AIS, while they are
more conservative and refrain from offering reperfusion
ESO East Supplement 2023

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